The show generally revolves around retro game reviews that involve bitter rants against particularly low-quality or poorly designed video games. The series began as a feature on YouTube, and later joined ScrewAttack Entertainment, which would later have three of its features, including the AVGN, transferred to GameTrailers exclusively. The show was formerly known as The Angry Nintendo Nerd, a title that was abandoned to avoid legal issues due to the Nintendo trademark, and because the show started reviewing games on other consoles.

The titular Nerd character is an ill-tempered and foul-mouthed video game fanatic. He derives comic appeal from excessive and inventive use of profanity, frequent displays of explicit gestures, and heavy consumption of beer,particularly Rolling Rock or Yuengling, to "soothe the pain". A particular characteristic is his favorable comparison of extremely repulsive and painful, usually firmly scatological, acts to playing the games he reviews. Varying amounts of physical comedy are mixed into the verbal abuse.

The Angry Video Game Nerd show originated on YouTube under the JamesNintendoNerd Channel, where it was known as the Angry Nintendo Nerd show until November 15, 2006. The show was aired entirely on YouTube until James Rolfe joined with ScrewAttack, after which the YouTube account was used only for trailers and miscellaneous videos. On July 25, 2008, older episodes that were exclusive only to Gametrailers started being gradually uploaded to the JamesNintendoNerd Channel for the YouTube subscribers.